VA Form 21-22: Appointment of Veterans Service Organization as Claimant's Representative

What VA Form 21-22 is for

Use this form to appoint a recognized Veterans Service Organization to help prepare, present and pursue your VA claim. VA's representation guidance says VSO representation is free. Contact the organization first and confirm it will help you. This form does not file a claim or decision review by itself.

Appointing an individual attorney or claims agent instead of an organization? That is VA Form 21-22a. Fill out Form 21-22a.

Parts someone else completes

The organization's representative completes Section III, items 15 to 18: the organization's name, the representative's name and job title, the organization's email, and the date of the appointment. Ask them to check Item 15, since an office's familiar local name may differ from the recognized organization's name. The representative named in 16A also signs and dates items 23A and 23B. VA completes the VA use only box.

What you fill in by hand

The filler never asks for your Social Security number, VA file number, date of birth or signature. You write those in by hand. Leave these boxes for yourself:

• Item 2: veteran's Social Security number (and the copy at the top of page 2)
• Item 3: VA file number
• Item 4: veteran's date of birth
• Item 5: service number
• Item 11A: claimant's date of birth
• Items 22A and 22B: your signature and date

Where to send it

• Both signatures belong on the form before it goes to VA: yours in 22A and 22B, and the representative's in 23A and 23B.
• Online: VA's appointment tool can prepare the form. If it gives you a PDF to sign, finish both signatures and submit it through QuickSubmit in AccessVA.
• Participating organizations can also accept an electronic 21-22 request through VA's Accredited Representative Portal. Ask your organization which route it uses.
• Compensation claims by mail: Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.
• Pension and survivor benefit claims by mail: Department of Veterans Affairs, Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365. A Board appeal: Department of Veterans Affairs, Board of Veterans' Appeals, PO Box 27063, Washington, DC 20038.
• In person: bring the signed form to a VA regional office.
• Keep a copy. Confirm with your representative that VA recognizes the appointment, and keep working on any claim or appeal deadline meanwhile.

Claim Raven does not submit forms to VA. You review the filled PDF, sign and date it, and send it to VA yourself. Claim Raven is independent and is not affiliated with VA.

Official form and guide

• VA's page for Form 21-22 on VA.gov
• VA Form 21-22 example and how to fill it out

This filler uses the July 2023 edition of the form.